How we hold providers to account

NHS Clinical Commissioning groups plan, buy and test the quality of most of the NHS services you use

NHS Clinical Commissioning groups plan, buy and test the quality of most of the NHS services you use

As your local commissioning group our role is to plan, buy and test the quality of local hospital, community and mental health services provided by the NHS.  We are accountable to you and NHS England for your local NHS services.

In this section, you will also find out other ways in which we hold our providers - the organisations who deliver your services - to account to ensure they deliver high quality, safe and patient focused services. As well as the examples below we also work in partnership with our providers and partners when it comes to patient and public engagement by linking in with their engagement platforms.

Follow this link for a copy of our mapping of Newham Providers and Partners Patient and Public Engagement Platforms

How we hold NHS services to account?


Community Health Services undertake a quarterly Patient Reported Outcome Measure and Patient Reported Experience Measure audit with our patients.

Where the findings indicate service needs improving, we ask our provider to undertake a review to make improvements.

What changed?

·       Majority of the patients report positive outcomes around the following:

    • Mobility
    • Self Care
    • Pain or Discomfort
    • Performing Usual Activities
    • Anxiety or Depression
  • Where a service particularly reported poor experience and outcomes, we have seen leadership and service changes which has resulted in patients reporting improved experiences.
Friends and Family Test
  • The CCG regularly monitors the Friend and Family Test response rates and scores.
  • This is discussed regularly at the CCG’s Clinical Quality Review Meeting (CQRMs) where response rates have been low or scores have been negative. 
What changed?
  • Response rates in inpatients at Newham Hospital overall have been at a good level with patients reporting positively.
  • Across A&E many initiatives have been put in place to improve response rates by engaging with patients, volunteers and use of IT initiatives.
  • Across Community Health over 2015-16 we have seen significant improvements in response rates, with majority of patient’s response being positive.
  • We have also soon improvements in Mental Health Services. Various initiatives have been put in place such as tablet devices to engage patients in order to receive feedback around patient experience

Patient Complaints
  • Through the CQRM reporting we ask our providers to report on patient complaints on a monthly basis and discuss lessons learned.
  • This enables the CCG to understand the care and delivery problems that impact on patient experience and discuss actions to improve quality.
What changed?

Newham University Hospital, Barts Health

  • Through the Newham Hospital governance structures and newsletters the hospital shares key themes from complaints across the hospital.
  • Themes, trends and learning are also shared at safety huddles with staff so there is shared learning and improvement across all wards.

East London Foundation Trust (Mental Health & Community Health)

  • Complaints are used for learning and improvement and by the Trust. Where the complaint offers an opportunity for wider system change and improvement the Trust uses their quality improvement methodology through a PDSA cycle to make improvements.
KPIs and reporting schedules on contracts

Patient experience Key Performance Indicators (KPI) on all our contracts.  They are developed based on national/regional standards and our local community intelligence.

What changed?
  • The KPIs are monitored on a monthly basis through contractual service performance review meetings and clinical quality review meetings.
  • Enabling NCCG to closely monitor performance and quality and hold the provider to account on delivery, and request improvement plans were there are areas of concerns
Maternity Quality and Performance Group

Newham specific Maternity Quality & Performance Meeting which meets on a monthly basis to review the quality of care that is being delivered at Newham University Hospital. 

 What changed?
  • In collaboration with staff from the maternity service, supports the CCGs to look at ways to improve patient experience.
  • The CCG is regularly receiving a Maternity Dashboard to closely monitor activity and quality. The dashboard provides baseline data that is explored in detail at the meeting. 

Quality Assurance (QA) Visits

The CCG undertakes QA visits jointly with Healthwatch to observe first-hand the quality of care, including patient/family feedback.  Visits are based on intelligence the CCG receives through its own intelligence and assurance processes.

 What changed?
  • The CCG undertakes joint Quality Assurance Visits with Healthwatch (key element is patient experience).
  • We use intelligence and information from the Quality Assurance Visit to celebrate good practice and identify areas for improvement. Healthwatch attend this meeting with the provider to feedback on patient experience. 

Amber Alerts
  • Amber Alert process was set up for GPs to provide patient feedback at practice level about our two main providers – Barts Health and East London Foundation Trust.
  • The CCG on behalf of the patient and the practice will coordinate and resolve issues raised and share learning.
 What changed?

From April 2015 to March 2016theCCG received a total of 184 Amber Alerts. Outcomes:

  • Patients waiting for appointments have now been given appointments.
  • Patients in the community who have not been followed up and seen appropriately now have robust plans in place.
  • Waiting time for test results have improved.
  • Policy and procedures updated.
  • New systems designed to improve communication with patients.
  • Staff offered training and education to build understanding of policies and procedures.